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what kind of disease is Kawasaki?
small-medium vessel systemic vasculitis
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why is Kawasaki's disease an important diagnosis to make?
as aneurysms of coronary arteries are important complication!
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what % of cases are affected by coronary artery aneurysm?
1/3
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what age group goes KD affect?
- 6 month - 4 year
- peak 1 year
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who is KD more common in?
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what is cause of KD?
- unknown
- maybe bacterial toxin acting as superantigen
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how is diagnosis of KD made?
- based on clinical findings
- need 5 out of 6 of:
- 1. fever for 5 days or more
- 2. rash: polymorphous
- 3. bilateral conjunctival injection (non purulent)
- 4. Lips: red, dry, cracked, strawberry tongue
- 5. extremities
- - red palms and soles
- - indurative oedema of handset
- - peeling of skin on hands and feet
- 6. cervical lymphadenopathy: can be unilateral, non purulent
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what is differential diagnosis of KD?
- measles
- rubella
- scarlet fever
- roseola
- parvovirus B19
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which Ix need to be done in suspected KD?
- FBC, ESR
- LFT, U&E
- Throat swab, ASOT
- Blood culture, viral titre
- Echo
- ECG
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why is echo done?
detect coronary artery aneurysm
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what is the most effective Rx of KD? and when?
- IvIg 2g/kg within first 10 days
- reduces coronary artery aneurysm
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apart from IvIg what else is given and why? and dose?
- aspirin to reduce thrombosis risk
- first at high anti-inflammatory dose until fever subsides
- then low anti-platelet dose
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